Death of the Good Doctor - Faulty medical information has human consequences

[Guest guest]

Dear Group,

 

Whatever the intentions of this doctor, the truth about medicine and it's body

of knowledge wil never come out.

 

This list of drugs that went from the good list to the bad list is really pretty

much the story of most drugs. They are hailed as near miracles when they come

out. Then slowly but surely they are found to be bad. But never fear... they

then have a whole new crop of them, step a little closer, look right here, to

take their places. And even on occaision, they will resurrect one or two to

begin life anew in another name and a new disease entirely before it too becomes

bad again. Another good way to study the progress of most medical treatments

would be to study it as a business model of marketing products.

 

 

> JustSayNo

> Sun, 25 Jul 2004 18:44:25 -0400

> [sSRI-Research] " Death of the Good Doctor "

> - Faulty medical information has human consequences

>

> [-- Paragraph 18 reads: " That is precisely why the

> deliberate deceit of medical knowledge is morally

> corrupt and inhumane. Why it is unconscionable when

> pharmaceutical companies intentionally withhold

> meaningful information about their drugs, or when

> research fraud is committed? Why it is cruel when

> pseudo-knowledge comprised of marketing hype or

> over-reaching claims for drugs and devices is

> disguised as medical truth? Why it is immoral when

> the untested use of a drug is promoted in off-label

> prescribing for diseases? At the most fundamental

> level, tampering with medical truth violates the

> sanctity of human life " .]

>

>

>

>

> Faulty medical information has human consequences

>

>

http://www.timesstar.com/Stories/0,1413,125~1511~2293828,00.html

>

> IT happened in the Geriatrics Clinic, while my

> illustrious colleague, Dr. Michael Fein, was

> lecturing medical residents about osteoporosis

> treatments.

>

> When he began his review of estrogen replacement

> therapy, he stopped mid-sentence, looked knowingly

> at me, and said, " I feel awful about having promoted

> estrogen to so many women throughout my career. But

> that's what the 'evidence' told us to do back then. "

>

> " I know, " I sadly agreed. " I think about the

> millions of women we all encouraged to take estrogen

> over the last several decades, wrongly advising them

> that the hormone might protect against heart

> attacks, strokes and dementia. "

>

> I turned to the residents and said, " We didn't know

> until recently that estrogen may actually worsen

> these conditions. "

>

> The official lecture veered off into a deeply

> personal conversation between the two of us

> old-timers. The residents listened attentively as we

> talked about the pendulum swings during our medical

> careers that directed us from one dogmatic belief

> about the treatment of human illness to yet another:

>

> Thalidomide good, thalidomide bad during pregnancy.

>

> Arthroscopic surgery good, arthroscopic surgery

> ineffective for knee osteoarthritis.

>

> Electroconvulsant therapy good, bad, sometimes good

> for depression. Etc.

>

> We also talked about paradigm shifts in our basic

> understanding about human disease throughout the

> decades:

>

> PMS definitely didn't exist, and then it definitely

> did.

>

> High systolic blood pressures could be ignored, and

> then they should always be monitored and treated.

>

> Women rarely had heart attacks; women died most

> frequently because of heart attacks.

>

> Ulcers were caused by acid and stress, ulcers were

> caused by bacteria. Etc.

>

> If you practice medicine long enough, you will

> stumble into multiple humbling encounters that

> remind you about the complexity and instability of

> medical truths. After inadvertently injuring a few

> patients with your well-honed but ultimately invalid

> medical knowledge, you may become somewhat jaded or

> circumspect about the medical advice you offer. You

> might feel guilty or complicit with the harm your

> patients suffered, even if you fashioned your

> recommendations and treatments from the best

> evidence available at the time.

>

> You come to know that medical truth can be

> inherently slippery. You accept the fact that all

> medical knowledge is unfinished business, and you

> expect revised understandings about health and

> disease to evolve from innovative research.

>

> You appreciate the importance of being earnest in

> your pursuit of this knowledge, even if you realize

> that it may later prove to be false.

>

> You also understand that it is hard enough for a

> patient to be sick, and it is hard enough to be a

> doctor who takes responsibility for the suffering of

> another human being. You realize that negotiating

> your patient's illness will require you to marshal

> the best medical truths to guide him or her towards

> successful healing. You will want to rely on the

> most accurate evidence that illuminates a cause and

> a cure for your patient's suffering.

>

> That is precisely why the deliberate deceit of

> medical knowledge is morally corrupt and inhumane.

> Why it is unconscionable when pharmaceutical

> companies intentionally withhold meaningful

> information about their drugs, or when research

> fraud is committed? Why it is cruel when

> pseudo-knowledge comprised of marketing hype or

> over-reaching claims for drugs and devices is

> disguised as medical truth? Why it is immoral when

> the untested use of a drug is promoted in off-label

> prescribing for diseases? At the most fundamental

> level, tampering with medical truth violates the

> sanctity of human life.

>

> A few weeks ago, I wrote about the damaging practice

> of information-withholding by drug manufacturers who

> selectively suppress unfavorable results of their

> drug trials in the public domain. In essence, this

> tends to deprive us of important medical knowledge

> about drug inefficacy or side effects.

>

> In my next column, I will explore the alternate

> phenomenon of promoting unproven information about

> drugs, creating unverified drug claims that parade

> as medical knowledge.

>

> In the future, we will also look at publication

> bias, research fraud, data manipulation, and

> marketing and media influences that bend, shape and

> distort the troubled body of our medical knowledge.

>

> MY intention in this column is to underscore the

> utterly human consequences of these distorting

> influences and to locate the significance of these

> distortions in the very real lives of beleaguered

> patients and doctors.

>

> Each of us has a critical stake in the integrity of

> the body of our medical knowledge. In times of

> illness, we will look to that body as though looking

> into a mirror, searching for truths that will guide

> us through our suffering and despair. It's a matter

> of grave reflection.

>

> Kate Scannell is a physician with Kaiser Permanente

> and the author of " Death of the Good Doctor " .

>

>

> [Non-text portions of this message have been

> removed]

>

>

>